11D1042594 CLIA NUMBER - VININGS MEDICAL CENTER PC

Laboratory Demographics

CLIA Number: 11D1042594

Facility Name: VININGS MEDICAL CENTER PC

Facility Address:
2255 CUMBERLAND PARKWAY BUILDING 1400
ATLANTA, GA
ZIP 30339
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Facility Phone Number: 770 955-9477

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1740257435

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1042594
LAB Type	Physician Office
Facility Name	VININGS MEDICAL CENTER PC
Street	2255 CUMBERLAND PARKWAY BUILDING 1400
City	ATLANTA
State	GA
ZIP	30339
Phone	770 955-9477
CertificateType	3
CertificateEffectiveDate	7/5/2023
CertificateExpirationDate	7/4/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024